Natural alternatives for endometriosis

My 26-year-old niece has been diagnosed with endometriosis and suffers terribly with the pain. She’s keen to find holistic treatments. Is there any research on natural remedies for endometriosis?

S.G., via email

Endometriosis is a common gynecological condition in which tissue similar to the lining of the womb (endometrium) is found elsewhere in the body—most commonly in the ovaries, fallopian tubes and abdomen. This tissue behaves just like the endometrium, bleeding during menstruation, and can cause fibrous adhesions to form between organs, making them stick to each other. 

Although some women may have no noticeable symptoms, others are badly affected with severe pain, excessive bleeding, bladder and bowel problems and persistent exhaustion and tiredness. Endometriosis can also cause infertility.

The standard treatments for the condition—painkillers, hormonal drugs and surgery—often don’t work long-term and come with significant risks. Gonadotropin-releasing hormone (GnRH) agonists, for example, among the most popular drugs for the condition, can cause menopause symptoms such as hot flashes, insomnia and vaginal dryness.1

The good news is that there are natural options showing a lot of promise for treating endometriosis, especially the pain it can cause. Your niece’s best bet would be to see a functional medicine practitioner specializing in conditions like endometriosis, but here’s what the science says may help to relieve symptoms. 

Acupuncture

This ancient Chinese needling technique can reduce endometriosis-related pain as well as blood levels of CA-125, a protein that tends to be markedly elevated in cases of advanced endometriosis.2 In one study, acupuncture was more effective than the drug danzol at improving painful and irregular periods, back pain and other symptoms of endometriosis and had fewer side-effects.3 The technique also appears to help with infertility due to endometriosis.4

To find an acupuncturist near you visit www.acunow.org.

Traditional Chinese herbs

Chinese herbal medicine is routinely used to treat endometriosis in China, and a review comparing it to standard hormone drugs for symptom relief found it to be just as effective as gestrinone and more effective than danazol, but with fewer side-effects.5

Visit www.atcm.co.uk in the UK or www.nccaom.org  in the US to find a qualified practitioner who can tailor-make an herbal remedy specifically for you and your condition.

Propolis

This gummy substance, collected by honeybees from leaf buds and tree bark, may be helpful for treating infertility associated with endometriosis. In a preliminary trial of women with infertility and mild endometriosis, those who took supplements of bee propolis for six months enjoyed a pregnancy rate of 60 percent compared with only 20 percent among those taking a placebo.7 Propolis also appears to relieve painful periods.8

Suggested dosage: 500 mg twice a day

Diet

Some evidence suggests that certain dietary factors may be linked to endometriosis, so the following simple steps could help.

Cut the caffeine. Women drinking the equivalent of around one and a half cups of coffee a day are nearly twice as likely to have endometriosis and be infertile as a result.9

Fill up on fruit and veg. In a study of more than 1,000 women, those with higher intakes of fresh fruit and green vegetables were less likely to have endometriosis. Eating lots of beef and red meat, on the other hand, appeared to raise the risk.10

Get good fats. Omega-3 fatty acids, found in fatty fish like salmon as well as nuts and seeds, seem to have a protective effect against endometriosis. But women who go for foods filled with trans fats, such as processed fried and baked goods, are nearly 50 percent more likely to have the condition.11

Give up gluten.  A gluten-free diet relieved painful symptoms of endometriosis in 75 percent of patients after 12 months. Physical functioning, vitality and mental health also improved.12

Antioxidants

Women with endometriosis tend to have lower intake of antioxidants (vitamins A, C and E, zinc and copper), so getting more of these nutrients through diet and supplements may help.13 In fact, studies show that certain antioxidant supplements can have a beneficial effect on the condition.

Vitamins C and E. A study of women with pelvic pain and endometriosis found that two months of treatment with vitamins C and E led to a reduction in chronic pain in more than 40 percent of the women.14

Suggested dosages: 1,200 IU/day vitamin E and 1g/day vitamin C

Pycnogenol. This standardized extract of French maritime pine bark, rich in flavonoids, slowly but steadily reduced symptoms of endometriosis in one preliminary study.15

Suggested dosage: 60 mg/day

N-acetylcysteine (NAC). Taking this antioxidant for three months was associated with a greater likelihood of canceling planned surgery for endometriosis compared to the no-treatment group.16

Suggested dosage: 1,800 mg/day

Try these herbal recommendations

According to herbalist Meilyr James, owner of the Herbal Clinic in Swansea, Wales
(www.herbalclinic-swansea.co.uk), endometriosis is often linked to overactivity of the adrenals, and this must be addressed for the body to heal. He recommends nervines—herbs that work on the nervous system of the body— to calm the overactive response, as well as herbs that work more directly on the uterus and female reproductive system.

Ashwagandha (Withania somnifera). This is a very grounding nerve tonic that helps the body deal with stress and anxiety, says James. 

How to take: Take as a powder; mix one rounded teaspoon with a little warm plant milk and drink in the evening. Like most tonic herbs, it can take a few weeks for a noticeable effect, but can be used safely over a longer duration.  

Bethroot (Trillium erectum). This herb is anti-hemorrhagic, says James, helping to reduce excess bleeding while having a protective and healing effect on endometrial tissue. 

How to take: Use a 1:3 tincture and take with yarrow and oat straw (see below)

Yarrow (Achillea millefolium). This herb helps to regulate menstrual flow and reduces cramping of the uterus, says James. 

How to take: Use a 1:4 tincture and take with bethroot and oat straw (see below)

Oat straw (Avena sativa). This soothing herb acts as a nourishing nervine, says James.

How to take: Use a 1:3 tincture and mix equal parts oat straw, bethroot and yarrow in a container. Take 1 tsp (5 mL) in water twice daily

 

References

1 

Cochrane Database Syst Rev, 2009; (3): CD006568

2 

PLoS One, 2017; 12: e0186616

3 

Zhongguo Zhen Jiu, 2006; 26: 863–5

4 

Gynecol Endocrinol, 1992; 6: 171–81

5 

Cochrane Database Syst Rev, 2012; (5): CD006568

6 

J Altern Complement Med, 2017; 23: 45–52

7 

Fertil Steril, 2003; 80(Supplement 3): 32

8 

Obstet Gynecol Sci, 2019; 62: 352–6

9 

Am J Epidemiol, 1993; 137: 1353–60

10

Hum Reprod, 2004; 19: 1755–9

11

Hum Reprod, 2010; 25: 1528–35

12

Minerva Chi, 2012; 67: 499–504

13

Reprod Biol Endocrinol, 2009; 7: 54

14

Transl Res, 2013; 161: 189–95

15

J Reprod Med, 2007; 52: 703–8

16

Evid Based Complement Alternat Med, 2013; 2013: 240702